Total parenteral nutrition with lipid

The efficacy of TPN, with lipid as the major source of calories, was assessed with body composition measurements. A multiple isotope dilution technic was employed to measure body composition before, at two week intervals during, and at the completion of a course of TPN. All the patients received equal volumes of a 10 per cent Intralipid solution and a solution containing 7 per cent L-amino acids with 10 per cent fructose (Vamin). The mean daily change in exchangeable potassium (ΔKe/day), a measure of the mean daily change in the body cell mass, was correlated with the number of kcal/kg/day infused to determine the efficacy of the solution. The correlation was not statistically significant. However, it became statistically significant (p < 0.05) when the patients without malnutrition were excluded, as their body cell mass was not expected to increase regardless of the amount of calories and protein infused. The resultant regression line indicated that the body cell mass was maintained when 44.2 kcal/kg/day was infused. However, the slope of the curve indicated that the body cell mass did not increase significantly when calories in excess of this amount were infused. The Intralipid and Vamin combination successfully maintained a normal body cell mass but did not rebuild one that was depleted. In addition, the data emphasize the importance of knowledge of a patient's preexisting nutritional status in evaluating the response to TPN.